Concurrent chemotherapy-radiotherapy compared with radiotherapy alone in locoregionally advanced nasopharyngeal carcinoma: progression-free survival analysis of a phase III randomized trial.

PURPOSE: Nasopharyngeal carcinoma (NPC) is highly sensitive to both radiotherapy (RT) and chemotherapy. This randomized phase III trial compared concurrent cisplatin-RT (CRT) with RT alone in patients with locoregionally advanced NPC. PATIENTS AND METHODS: Patients with Ho's N2 or N3 stage or N1 stage with nodal size > or = 4 cm were randomized to receive cisplatin 40 mg/m(2) weekly up to 8 weeks concurrently with radical RT (CRT) or RT alone. The primary end point was progression-free survival (PFS). RESULTS: Three hundred fifty eligible patients were randomized. Baseline patient characteristics were comparable in both arms. There were significantly more toxicities, including mucositis, myelosuppression, and weight loss in the CRT arm. There were no treatment-related deaths in the CRT arm, and one patient died during treatment in the RT-alone arm. At a median follow-up of 2.71 years, the 2-year PFS was 76% in the CRT arm and 69% in the RT-alone arm (P =.10) with a hazards ratio of 1.367 (95% confidence interval [CI], 0.93 to 2.00). The treatment effect had a significant covariate interaction with tumor stage, and a subgroup analysis demonstrated a highly significant difference in favor of the CRT arm in Ho's stage T3 (P =.0075) with a hazards ratio of 2.328 (95% CI, 1.26 to 4.28). For T3 stage, the time to first distant failure was statistically significantly different in favor of the CRT arm (P =.016). CONCLUSION: Concurrent CRT is well tolerated in patients with advanced NPC in endemic areas. Although PFS was not significantly different between the concurrent CRT arm and the RT-alone arm in the overall comparison, PFS was significantly prolonged in patients with advanced tumor and node stages.

Synthesis of novel magnetic iron metal-silica (Fe-SBA-15) and magnetite-silica (Fe(3)O(4)-SBA-15) nanocomposites with a high iron content using temperature-programed reduction.

Magnetic iron metal-silica and magnetite-silica nanocomposites have been prepared via temperature-programed reduction (TPR) of an iron oxide-SBA-15 (SBA: Santa Barbara Amorphous) composite. TPR of the starting SBA-15 supported Fe(2)O(3) generated Fe(3)O(4) and FeO as stepwise intermediates in the ultimate formation of Fe-SBA-15. The composite materials have been characterized by means of x-ray diffraction, high resolution transmission electron microscopy and SQUID (superconducting quantum interference device) magnetometry. The Fe oxide and metal components form a core, as nanoscale particles, that is entrapped in the SBA-15 pore network. Fe(3)O(4)-SBA-15 and Fe-SBA-15 exhibited superparamagnetic properties with a total magnetization value of 17 emu g(-1). The magnetite-silica composite (at an Fe(3)O(4) loading of 30% w/w) delivered a magnetization that exceeded values reported in the literature or obtained with commercial samples. Due to the high pore volume of the mesoporous template, the magnetite content can be increased to 83% w/w with a further enhancement of magnetization.

The effect of acupuncture on essential hypertension.

Twenty-eight patients with essential hypertension were treated with acupuncture therapy. Sixteen showed excellent improvement in terms of the lowering of blood pressure to normal and the disappearance of original symptoms. Eight had moderate improvement and 4 showed no response. The results of treatment seem to indicate that improvement is closely related to the duration of disease and the history of drug treatment. The selection of acupuncture loci and the techniques of needle insertion and manipulation are discussed in detail.

Acupuncture for several functional disorders. Part I.

This is Part I of a study whose purpose is two-fold, that is, to arrive at a classification of diseases under investigation according to their responsiveness to acupuncture therapy, and to discuss and identify the most effective loci for the diseases investigated. In Part I of this study, over 500 patients afflicted with hyperthyroidism, trigeminal neuralgia or intercostal neuralgia were treated with acupuncture therapy. The results of the treatment, together with the selection of acupuncture loci and the techniques of needle manipulation are reported in detail. Over 80% of the patients were found to have made excellent improvement. The three diseases are therefore classified as diseases on which acupuncture therapy yields excellent results.

Efficacy of a specially designed hip protector for hip fracture prevention and compliance with use in elderly Hong Kong Chinese.

BACKGROUND: Hip protectors, while effective in prevention of hip fractures, have been designed for a Caucasian body build and may not be suitable for Asian subjects living in a subtropical climate. OBJECTIVE: Hip protectors and accompanying shorts were specially designed for use for the Chinese body build and subtropical climate, and tested for compliance and efficacy in fracture prevention. METHOD: A pragmatic study examining compliance with the wearing of hip protectors, and effectiveness in preventing hip fractures (using a case control design), in 302 subjects wearing hip protectors and 352 control subjects. RESULTS: Overall compliance varied from 55 to 70%. The relative risk for hip fracture was 0.18 (0.04-0.79), relative risk reduction 82%, and the number of subjects needing to wear a hip protector to prevent one fracture was 33 (19-117). CONCLUSION: Hip protectors adapted for use in Chinese people appear to reduce hip fractures in routine clinical practice.

Combination gemcitabine and cisplatin chemotherapy for metastatic or recurrent nasopharyngeal carcinoma: report of a phase II study.

BACKGROUND: To evaluate the efficacy and toxicity of combination gemcitabine plus cisplatin (GC) chemotherapy in metastatic or recurrent nasopharyngeal carcinoma (NPC). PATIENTS AND METHODS: Forty-four patients of Chinese ethnicity with metastatic or recurrent NPC received ambulatory GC chemotherapy every 28 days (gemcitabine 1000 mg/m(2) days 1, 8 and 15; cisplatin 50 mg/m(2) days 1 and 8). There were 40 male and four female patients with a mean age of 47.4 years. More than half (54.5%) of the patients had received either prior platinum-based chemotherapy and/or radiotherapy to target lesions. RESULTS: There were nine complete responses and 23 partial responses in the 44 patients, achieving an overall response rate of 73% (78% for the 41 assessable patients). The mean duration of response was 5.3 months. Improved subjective symptom-control scores were found in 78% of patients with pre-existing symptoms, while 64% of patients experienced improved general well-being scores. Toxicity was mainly hematological: grade III/IV anemia, granulocytopenia and thrombocytopenia were found in 11, 37 and 16% of cycles, respectively. With a median follow-up of 17.2 months, 62% survived 1 year while 36% were alive and progression free. CONCLUSIONS: Gemcitabine plus cisplatin chemotherapy offers a satisfactory overall response rate, subjective patient improvement and safety profile for metastatic and recurrent NPC.